Free Mortgage Amortization Schedule

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					                                                                                               Correspondent Information
                                                                                      Name:
                                                                                      Phone:




Thank you for your interest in CGB AGRIfinancial Services Loan Programs. In order
  to understand your operation and evaluate your credit request, we will need the
           following information, based on the type of credit requested.

              Initial Information Requirements for each Applicant, Co-Maker and Guarantor:

                      For an Real Estate Loan, please complete #1 - #16
    #1          A completed and signed application for credit

    #2          Current balance sheet, no more than 90 days old, and prior 3 years of balance sheets, for
                each entity on the application

    #3          Current year federal tax return, or year-to-date profit & loss statement, and prior 3 years
                of federal tax returns, for each entity on the application

    #4          Projected production and yield estimates for current crop year
    #5          5 year historical production history

    #6          Completed Creditor Sheet and/or copies of debt instruments (note, mortgage,
                amortization schedule, etc.)

    #7          Brief narrative/description of farming operation

    #8          Copy of most recent appraisal(s), if available

    #9          Copies of signed purchase agreement(s), if applicable

   #10          Copies of bid(s), if construction is involved

   #11          Copies of production contracts, if applicable

   #12          Typical cash flow scenario provided by integrator (poultry, swine, etc.)

   #13          12 - 15 month cash flow projection & marketing plan for coming year with detail on each
                unit or entity (not applicable for real estate loans)

   #14          List of locations where grain sold (not applicable for real estate loans)
                     These items can be submitted after approval, but prior to closing

   #15          For entity applicants, Articles of Incorporation & Bylaws, Partnership Agreements, or
                other organizational documents

   #16          Insurance coverage information; attach a copy of the declarations pages and coverages
                for each
                       Crop insurance - necessary for operating loans
                       Farmowners insurance - necessary on all loans

Based on this information, we will evaluate your credit request, determine an approximate interest rate, and
identify any additional information requirements needed to make a final loan commitment. Financial
statements, cash flow, and other data collection forms are available for your convenience should you need
them. Please feel free to contact us with any questions at our toll-free number: 877-548-2622.

            Thank you once again for your interest in CGB AGRIfinancial Services




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                                                      Printed 11/27/2010
                                                                                                                                            2209 River Road, Louisville, KY 40206
                                                                                                                                         502/721-9446 - phone • 502/721-9776 - fax
                                                                                                                                                           877-548-2622 - toll free
                                                                                                                                                            FinanceInfo@cgb.com
                                                                                                                                                                 www.cgb-afs.com

                                                                                                                                                                 Credit Application
1a. Customer Name(s)                  1b. Entity Type           1b.   SS or TIN               1c. Birthdate          1d.   Year Began Farming                  1e.       Primary Ag Product




2. Mailing Address                                              3. Telephone Numbers                                                  4. Email Address
                                                                               Residence:
                                                                                    Office:
                                                                                      Fax:
2a. Length of Time at Address:                                                     Mobile:
5. Business Information
Liability Insurance:                                            Crop Insurance:                                                           Current Lender:
Insurance Agent:                                                        Insurance Agent:                                                            Contact:
        Address:                                                                  Address:                                                          Address:
        Address:                                                                  Address:                                                          Address:
      Telephone:                                                               Telephone:                                                      Telephone:
6. Description of Loan Requested
   Operating Line of Credit Amount                                            Due when?
          Real Estate Loan Amount                                                    Term                             Amortization              1              Payments per Year             2
                          Equipment                                                  Term                                  Maturity                            Payments per Year
           Specific Purpose of Loan

7. Real Property Offered to Secure Real Estate Loan
      Total Acres                            Property Address                                                                         Title to vest in what name(s)?
   Tillable Acres                               County, State
  Pastured Acres                       Name of Public Road                                                                                          Title will be held as Sole/Joint Tenants/etc.
Mineral rights 100% owned?      Yes     No       Accessible by public road? Dwellings on property? Is one your principal residence?Annual Lease Amount
                                Yes     No              Yes    No              Yes     No               Yes        No                          (if leased)
Mineral rights leased?
8. Declarations, Representations and Warrants                                                                                                                        Applicant         Co-Applicant
                                                                                                                                                                 Yes        No         Yes       No
A. Are there any outstanding judgements against you? If yes, explain:


B. Have you, or any entity in which you have greater than a 10% ownership, been declared bankrupt within the past seven years?
   If yes, please indicate the type of bankuptcy, date of filing, and date of discharge, if any.
   Chapter 7 ___ Chapter 11 ___ Chapter 12 ___ Chapter 13 ___                                      Date of Filing:
                                                                                              Date of Discharge:
C. Have you, or any entity in which you have greater than a 10% ownership, had property foreclosed upon or
   given title or deed in lieu thereof in the last seven years? If yes, please explain:


D. Do you have MPCI Insurance or Federal Crop Insurance in force?
E. Did you have an MPCI or Federal Crop Insurance claim in the last five years?
   If yes, which years: ___2005 ___2006 ___2007 ___2008 ___2009
F. Are you a U.S. citizen or a permanent resident alien?
G. Are you a guarantor of any debts that are not reflected on current balance sheet statement? If yes, please explain:


H. Do you have any accounts that are past due by 30 days or more? If yes, please explain:


Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who applies for a loan. Your name, address, date of birth, and other
information used to identify you will be verified. You may also be asked to provide your driver's license or other identifying documents prior to closing your loan. I/We authorize CGB
Agri Financial Services and its affiliated lenders ("Lender"), to make all inquiries deemed necessary to verify the accuracy of the information contained herewith to determine my/our
credit worthiness. I/We intend that all credit data we have submitted to Lender be considered as part of this application. The information contained in the application is provided for
the purpose of obtaining business (non-consumer) credit with the Lender on behalf of the undersigned. It is understood Lender will rely on the information provided in making its credit
decision. The undersigned warrants and represents the information herein submitted is true and correct in all aspects and Lender may consider this representation continuing until
written notice to the contrary is received by the Lender from the undersigned. The Lender is hereby authorized to answer any questions from third parties concerning the
undersigned's experience with the Lender. I/We further agree and consent that Lender may obtain an appraisal of, and evidence of title to and existing liens on, the property offered
as security and that I/we are responsible for the payment of all costs of obtaining this information. It is the policy of CGB Agri Financial Services to not disclose any non-public
personal information about you or your operation except as authorized by you or as required by law.

No commitment is binding unless confirmed in writing.

The Applicant represents and declares that the proceeds of the loan will be used solely for business purposes.

                                       I HAVE READ, UNDERSTAND, AND AGREE TO MAKE THESE REPRESENTATIONS AND WARRANTS
                                                                                                                                      If a Partnership, Corporation or other entity:
      Applicant's
        Signature                                                                                                           Name


             Date                                                                 20_____                                       By


   Co-Applicant's                                                                                                             Title
        Signature
                                                                                                                              Date                                               20
             Date                                                                 20_____




                                                                             a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                                                                        Printed 11/27/2010
                                                                               CGB AGRI financial Services

  Name
Address
                                                                                           Financial Statement Date



CURRENT ASSETS                                  AMOUNT             CURRENT LIABILITIES                                         AMOUNT
Cash                  Savings                                      Accounts Payable                        (SCH - L & M)
Marketable Securities               (SCH - A)
Current Portion A/R                 (SCH - B)                      Operating Line                          (SCH - K)
Crops/Feed on Hand                  (SCH - C)
Supplies/Prepaid Expenses           (SCH - D)                      Federal Income Taxes
Investment In Growing Crops         (SCH - E)                      State Income Taxes
Livestock Held For Sale             (SCH - F)                      Real Estate Taxes
                                                                   Other Taxes


                                                                   Notes Payable - Prin due 1 yr.          (SCH - L & M)
                                                                   Current Portion of L/T Debt             (SCH - N, O, & P)
                                                                   Other Payables
                                                                   Accrued Interest                        (SCH - N, O, & P)
                                                                   Capital Leases - Prin due 1 yr.


                    TOTAL CURRENT ASSETS                                                   TOTAL CURRENT LIABILITIES


TERM ASSETS                                     AMOUNT             TERM LIABILITIES                                            AMOUNT
Breeding/Dairy Livestock            (SCH - G)                      Notes Payable - Prin due after 1 yr. (SCH - L & M)
Securities Not Readily Marketable   (SCH - H)                      Farm Real Estate Debt                   (SCH - N)
Personal Vehicles                   (SCH - I)                      Non Farm Real Estate Debt               (SCH - O)
Machinery and Equipment             (SCH - J)                      Other Long Term Debt                    (SCH - P)
                                                                   Capital Leases - Prin due after 1 yr.




Owned Real Estate - Farm Related (SCH -N)
Owned Real Estate - Non Farm        (SCH - O)
Other Long Term Assets              (SCH -P)
Leased Assets
                                                                                              TOTAL TERM LIABILITIES
                                                                                                     TOTAL LIABILITIES
                          TOTAL TERM ASSETS                                                                   NET WORTH
                                TOTAL ASSETS                                     TOTAL LIABILITIES AND NET WORTH



    I (WE) HEREBY CERTIFY THAT THE REPRESENTATIONS, STATEMENTS AND RELATED SCHEDULES HEREIN WERE
       CONSENTED TO OR MADE DIRECTLY BY ME (US) FOR THE PURPOSE OF INDUCING AMC TO GRANT THE LOAN
           REQUESTED AND THAT ALL SUCH STATEMENTS, REPRESENTATIONS, AND SCHEDULES ARE TRUE.




           SIGNATURE                                   DATE        SIGNATURE                                           DATE




           SIGNATURE                                   DATE        SIGNATURE                                           DATE




                                                a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                                           Printed 11/27/2010
                                                                   CGB AGRI financial Services
                                                                        Financial Statement Supporting Schedules

  Name
Address



MARKETABLE SECURITIES/HEDGING ACCOUNT (SCHEDULE A)             CURRENT PORTION OF ACCOUNTS RECEIVABLE
                                           MARKET              AND CONTRACTS RECEIVABLE (SCHEDULE B)
  NAME / ISSUE   # SHARES VALUE/SHARE       VALUE                                     DATE
                                                                 FROM WHOM            DUE                  VALUE




                            TOTAL                                                   TOTAL


CROPS / FEED ON HAND (SCHEDULE C)                              SUPPLIES AND PREPAID EXPENSES (SCHEDULE D)
                 UNITS ON
 DESCRIPTION      HAND         PRICE        VALUE               DESCRIPTION           PRICE                VALUE




                 TOTAL                                                              TOTAL


INVESTMENT IN GROWING CROPS (SCHEDULE E)                       LIVESTOCK HELD FOR SALE (SCHEDULE F)
                                                               DESCRIPTION &
 DESCRIPTION      ACRES       $/ACRE        VALUE                  WEIGHT            NUMBER     VALUE/HEAD         VALUE




                 TOTAL                                                                          TOTAL


BREEDING/DAIRY LIVESTOCK (SCHEDULE G)                          SECURITIES NOT READILY MARKETABLE (SCHED. H)
 DESCRIPTION     NUMBER     VALUE/HEAD      VALUE               NAME / ISSUE        # SHARES VALUE/SHARE           VALUE




                 TOTAL                                                              TOTAL


PERSONAL VEHICLES (SCHEDULE I)                                 PERSONAL VEHICLES (SCHEDULE I) CONT.
 YEAR             MAKE/MODEL                VALUE                    YEAR                   MAKE/MODEL             VALUE




                             SUB TOTAL                                                            SUB TOTAL
                                                                                                         TOTAL




                                         a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                                     Modified 5/29/01
                                                    Printed 11/27/2010
                                           CGB AGRI financial Services
                                           Agricultural Mortgage Company of America
                                              Financial Statement Supporting Schedules
     Name
   Address




MACHINERY AND EQUIPMENT (SCHEDULE J)

  YEAR             MAKE/MODEL                        SERIAL NUMBER           VALUE




                                                                     TOTAL




                          a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                      Modified 5/29/01
                                     Printed 11/27/2010
                                                             CGB AGRI financial Services
                                                                 Financial Statement Supporting Schedules

      Name
    Address



              OPERATING LOANS (SCHEDULE K)
                                             CURRENT       TYPICAL                ANNUAL
              DESCRIPTION       TO WHOM      BALANCE      BALANCE       % RATE    INT. DUE




                                   TOTALS


CAPITAL LEASES
                               MKT VALUE      LEASE                      TOTAL
                                 LEASE       MATURITY                   UNPAID    ANNUAL DUE AFTER RESIDUAL
COLLATERAL/LEASING CO.         COLLATERAL      DATE                   PAYMENTS PAYMENT       1 YEAR    PAYMENT




                      TOTALS


ACCOUNTS PAYABLE (SCHEDULE L)               NOTES PAYABLE (SCHEDULE L)
   DESCRIPTION        DATE                   PRINCIPAL    PAYMENT        PMTS    PORTION OFPRIN. DUE     INT.
     TO WHOM           DUE      AMOUNT       BALANCE       AMOUNT       PER YR            AFTER 1 YEARRATE (%)
                                                                                 ANN. PRIN.




                      TOTALS




                                      a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                                  Modified 5/29/01
                                                 Printed 11/27/2010
                                                                 CGB AGRI financial Services
                                                                     Financial Statement Supporting Schedules

    Name
  Address



OWNED REAL ESTATE - FARM RELATED (SCHEDULE N)
                                                                                                      INT. CURR.
  DESCRIPTION      PROPERTY NAME      MARKET      LIENHOLDER       PRINCIPAL     ANNUAL    ANNUAL       AS OF
        ACRES      COUNTY / STATE     VALUE        MAT. DATE       BALANCE       PMT AMT   INTEREST    % RATE




TOTAL                        TOTALS


OWNED REAL ESTATE - NON-FARM RELATED (SCHEDULE O)
                                                                                                      INT. CURR.
  DESCRIPTION      PROPERTY NAME      MARKET      LIENHOLDER       PRINCIPAL     ANNUAL    ANNUAL       AS OF
        ACRES      COUNTY / STATE     VALUE        MAT. DATE       BALANCE       PMT AMT   INTEREST    % RATE




TOTAL                        TOTALS


OTHER LONG TERM ASSETS (SCHEDULE P)
                                                                                                      INT. CURR.
  DESCRIPTION      PROPERTY NAME      MARKET      LIENHOLDER       PRINCIPAL     ANNUAL    ANNUAL       AS OF
                   COUNTY / STATE     VALUE        MAT. DATE       BALANCE       PMT AMT   INTEREST    % RATE




                             TOTALS




                                      a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                                  Modified 5/29/01
                                                 Printed 11/27/2010
                                                                 CGB AGRI financial Services
                                                                 Five Year Trend Analysis of Production History

      Name
    Address



                                                                                         Pro Forma
HISTORICAL ACRES OPERATED          2006            2007             2008       2009        2010      AVERAGE
CROPLAND OWNED
PASTURE OWNED
OTHER
              SUBTOTAL
CROPLAND RENTED/LEASED
PASTURE RENTED/LEASED
OTHER
              SUBTOTAL
TOTAL ACRES OPERATED



CROP PRODUCTION HISTORY
FIELD CORN - ACRES
AVERAGE YIELD


SOYBEANS - ACRES
AVERAGE YIELD


WHEAT - ACRES
AVERAGE YIELD



AVERAGE YIELD



AVERAGE YIELD


LIVESTOCK PRODUCTION HISTORY


PORK
NUMBER OF BRED GILTS/SOWS
PIGS WEANED AVG PER LITTER
NO MKT HOGS SOLD/AVG WT.
AVG $ PER CWT
FEEDER PIGS SOLD AVG WT


DAIRY
NO OF MILK COWS
ROLLING HERD AVERAGE
AVG $ PER CWT
CULL COWS SOLD
FEEDERS SOLD


BEEF CATTLE
# BRED BEEF COWS
CALVES WEANED
NO. FAT CATTLE SOLD
AVG. WEIGHT
AVG. $ PER CWT.
AVG. WEIGHT GAIN




                               a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                          Printed 11/27/2010
                                                                                                  CGB AGRI financial Services
                                                                                                                  Projected Production Detail

     Name
   Address


                                               Total                          Crop                            Unit        Operator            Operator
              Farm                 ASCS #      Acres           Crop           Acres           Yield           Price         %                 Income




                                      Total                           Total                                       Total Crop Income



            Livestock                                                          #                              Unit        Operator            Operator
            Projection                                       Product          Head           Weight           Price         %                 Income




                                      Total                           Total                                   Total Livestock Income
                                                                                                      Total Adjusted livestock income

Other Collateral
                                     Applicant Value         Discount           Discounted Value                  Prior Lien             Eligible Collateral
Defined Gov't Payments (not LDP)                                   75%
Bonds and Securities                                               75%
Accounts Receivables                                               50%
Market Livestock                                                   75%
Other Livestock Products                                           50%
Mach/Equip                                                         70%
Vehicles                                                           70%
Raised Breeding Stock                                              70%
Purchased Breeding Stock                                           70%
Notes Receivable                                                   50%
Land                                                               70%
Buildings                                                          50%




                                                                                                                Sum other Collateral


                                                                                                                      Total Collateral




                                                       a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                                                  Printed 11/27/2010
                                                                                                                                                                                                           CGB AGRI financial Services
                                                                                                                                                                                                                       Cash Flow Worksheet
                                       Name:                                                                                                                                                          Operating Year
CASH FARM INCOME                               Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10        Jul-10           Aug-10               Sep-10   Oct-10   Nov-10   Dec-10   Jan-11   Feb-11       Mar-11       Total Fiscal Year Crop
Livestock (Purchased for Resale)
Crops, livestock, & other products raised
Agricultural program payments
CCC loan taxable income
Custom hire income
Federal and state gasoline refunds
Livestock sales for capital gain (Sch. D)
Cooperative Distributions
Crop insurance proceeds
Other
GROSS FARM INCOME
                                               Jan-10   Feb-10   Mar-10   Apr-10   May-10   Jun-10        Jul-10           Aug-10               Sep-10   Oct-10   Nov-10   Dec-10   Jan-11   Feb-11       Mar-11       Total Fiscal Year Crop
EXPENSE
Chemicals
Machine Hire
Feed
Fertilizer and lime
Freight
Gasoline, fuel oil
Insurance
Interest-- Operating
Interest-- Non-Operating
Labor
Rent-equipment
Rent-land
Repairs and maintenance
Seeds, plants
Storage
Supplies
Taxes
Utilities
Veterinary and Breeding Fees
Other
CASH FARM OPERATING EXPENSE
NET CASH FROM OPERATIONS
OTHER CASH INCOME/EXPENSE
Wages, salaries, tips
Interest income
Dividend income
Capital Purchases
Capital Sales
Term Loan Principal Payments
Family Living Draws
Other
NET OTHER CASH INCOME/EXPENSE
NET CASH FLOW
BEGINNING CASH BALANCE
OTHER BEGINNING OL BALANCE
OTHER OL DRAWS
OTHER OL PAYMENTS
CGB OL LOAN DRAWS
CGB OL LOAN PAYMENTS
ENDING CASH BALANCE
CGB OPERATING LOAN BALANCE


                                                                                                     a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
                                                                                                                Printed 11/27/2010
                                            CGB AGRI financial Services
                                                                 Creditor List/Grain Sale Location

   Name
 Address


                               Creditor List
   Company name:                            Account #
Telephone number:
         Address:



   Company name:                            Account #
Telephone number:
         Address:



   Company name:                            Account #
Telephone number:
         Address:



   Company name:                            Account #
Telephone number:
         Address:



   Company name:
Telephone number:
         Address:



   Company name:                            Account #
Telephone number:
         Address:


                     Locations where grain sold:
   Company name:                                           Additional Information:
         Location:
Telephone number:
         Address:



   Company name:                                           Additional Information:
         Location:
Telephone number:
         Address:



   Company name:                                           Additional Information:
         Location:
Telephone number:
         Address:




                      a2a503c8-0da8-40ef-91d4-6176b08dc33d.xls
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DOCUMENT INFO
Description: Free Mortgage Amortization Schedule document sample